title: Emergency EC-IC bypass for symptomatic atherosclerotic ischemic stroke.
abstract: Previous studies have shown that extracranial-intracranial (EC-IC) bypass surgery has no preventive effect on subsequent ipsilateral ischemic stroke in patients with symptomatic atherosclerotic internal carotid occlusion and hemodynamic cerebral ischemia. A few studies have assessed whether an urgent EC-IC bypass surgery is an effective treatment for main trunk stenosis or occlusion in acute stage. The authors retrospectively reviewed 58 consecutive patients who underwent urgent EC-IC bypass for symptomatic internal carotid artery or the middle cerebral artery stenosis or occlusion between January 2003 and December 2011. Clinical characteristics and neuroimagings were evaluated and analyzed. Based on preoperative angiogram, responsible lesions were the internal carotid artery in 19 (32.8%) patients and the middle cerebral artery in 39 (67.2%). No hemorrhagic complication occurred. Sixty-nine percent of patients showed improvement of neurological function after surgery, and 74.1% of patients had favorable outcome. Unfavorable outcome was associated with insufficient collateral flow and new infarction after bypass surgery.
authors.affiliation: Department of Neurosurgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan, tetuyosi@shinshu-u.ac.jp.
authors.forename: Tetsuyoshi
authors.initials: T
authors.lastname: Horiuchi
authors.forename: Junpei
authors.initials: J
authors.lastname: Nitta
authors.forename: Shigetoshi
authors.initials: S
authors.lastname: Ishizaka
authors.forename: Kohei
authors.initials: K
authors.lastname: Kanaya
authors.forename: Takao
authors.initials: T
authors.lastname: Yanagawa
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hongo
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000150:complications / Q000601:surgery*; D002545:Brain Ischemia / Q000209:etiology / Q000601:surgery*; D002533:Cerebral Angiography; D002536:Cerebral Arteries / Q000473:pathology; D002544:Cerebral Infarction / Q000517:prevention & control; D002548:Cerebral Revascularization / Q000379:methods*; D003097:Collateral Circulation / Q000502:physiology; D004632:Emergency Medical Services; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D002546:Ischemic Attack, Transient / Q000150:complications / Q000601:surgery; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D020127:Recovery of Function; D020521:Stroke / Q000209:etiology / Q000601:surgery*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator